OBJECTIVE To investigate the current status of water management for terminal rinsing of digestive en-doscope in medical institutions in Fujian Province,and to provide reference for improving regional quality control standards.METHODS An electronic questionnaire survey was conducted from Jul.2024 to Aug.2024 through convenient sampling in secondary and above hospitals of 9 prefecture-level cities in Fujian Province.The survey covered topics such as water treatment system configuration,maintenance and water quality monitoring.RESULTS A total of 108 questionnaires were distributed and 104 valid questionnaires were collected,with an effec-tive response rate of 96.30％.The survey revealed that 78.85％(82/104)of the hospitals adopted separate water supply for each department,and 82.69％used purified water for terminal rinsing.Only 19.23％installed the final filter membrane at the water outlet.In addition,66.35％of the hospitals did not specify the service life of the wa-ter supply pipeline,and the pipeline disinfection implementation rate was 60.58％,but 31.75％of them had ir-regular disinfection frequencies,with chlorine-based disinfectants(50.79％)and peracetic acid(34.92％)being the main disinfectants.The regular conductivity monitoring rate was 47.12％,and the microbial monitoring cov-erage rate reached 90.38％,with the monitoring frequency mainly being once every quarter(60.64％),but only 20.21％used R2A medium,and 12.77％adopted the membrane filtration method for inoculation.Tertiary hospi-tals were superior to secondary hospitals in terms of film membrane pore size pass rate(87.50％vs.56.86％),pipeline disinfection implementation rate(71.43％vs.50.91％)and advanced detection method application(P＜0.05).CONCLUSIONS There are issues in the management of water used for terminal rinsing of digestive endo-scopes in Fujian Province,including non-standard equipment maintenance,inconsistent monitoring methods and insufficient awareness among management personnel.It is recommended to enhance management quality by optimizing the water treatment system setup,establishing standardized monitoring procedures and strengthening professional training for personnel.

Objective To investigate the clinical characteristics and prognostic factors of Staphylococcus aureus bloodstream infections in adult patients for improving clinical treatment and identifying potential interventions.Methods Clinical data of inpatients diagnosed with S.aureus bloodstream infection confirmed by blood culture in a hospital from January 2016 to December 2023 were retrospectively reviewed.The data included patient age,gender,history of hospital admission,department of admission,underlying diseases,primary infection,quick Pitt bacteremia score(qPitt),invasive treatment,empirical anti-infective treatment,and treatment outcomes.Patients were assigned to case group or control group according to whether they died in hospital in order to identify the prognostic factors of patient outcomes.Binary logistic regression analysis was used to identify independent prognostic factors.Results A total of 233 cases of S.aureus bacteremia were identified.Multivariate logistic regression analysis showed that age ≥ 70 years old(OR=4.725,95％CI:1.228-18.173,P=0.024),diabetes mellitus(OR=8.161,95％CI:1.954-34.086,P=0.004),Charlson comorbidity index(CCI)≥ 5(OR=7.672,95％CI:1.901-30.963,P=0.004),hospital infection(OR=7.853,95％CI:1.588-38.832,P=0.012),and qPitt ≥ 2(OR=23.189,95％CI:4.461-120.552,P＜0.001)were independent prognostic factors for poor outcome of patients with S.aureus bacteremia,while catheter-associated infection(OR=0.051,95％CI:0.005-0.579,P=0.016)was negatively correlated with mortality.Conclusions Advanced age,diabetes mellitus,high CCI,hospital infection,and high qPitt were independent prognostic factors for poor outcomes of patients with S.aureus bacteremia.The patients should be well managed by timely removal of eradicable lesions to improve patient outcomes.

Objective To investigate the clinical characteristics and prognostic factors of Staphylococcus aureus bloodstream infections in adult patients for improving clinical treatment and identifying potential interventions.Methods Clinical data of inpatients diagnosed with S.aureus bloodstream infection confirmed by blood culture in a hospital from January 2016 to December 2023 were retrospectively reviewed.The data included patient age,gender,history of hospital admission,department of admission,underlying diseases,primary infection,quick Pitt bacteremia score(qPitt),invasive treatment,empirical anti-infective treatment,and treatment outcomes.Patients were assigned to case group or control group according to whether they died in hospital in order to identify the prognostic factors of patient outcomes.Binary logistic regression analysis was used to identify independent prognostic factors.Results A total of 233 cases of S.aureus bacteremia were identified.Multivariate logistic regression analysis showed that age ≥ 70 years old(OR=4.725,95％CI:1.228-18.173,P=0.024),diabetes mellitus(OR=8.161,95％CI:1.954-34.086,P=0.004),Charlson comorbidity index(CCI)≥ 5(OR=7.672,95％CI:1.901-30.963,P=0.004),hospital infection(OR=7.853,95％CI:1.588-38.832,P=0.012),and qPitt ≥ 2(OR=23.189,95％CI:4.461-120.552,P＜0.001)were independent prognostic factors for poor outcome of patients with S.aureus bacteremia,while catheter-associated infection(OR=0.051,95％CI:0.005-0.579,P=0.016)was negatively correlated with mortality.Conclusions Advanced age,diabetes mellitus,high CCI,hospital infection,and high qPitt were independent prognostic factors for poor outcomes of patients with S.aureus bacteremia.The patients should be well managed by timely removal of eradicable lesions to improve patient outcomes.

OBJECTIVE To investigate the current status of water management for terminal rinsing of digestive en-doscope in medical institutions in Fujian Province,and to provide reference for improving regional quality control standards.METHODS An electronic questionnaire survey was conducted from Jul.2024 to Aug.2024 through convenient sampling in secondary and above hospitals of 9 prefecture-level cities in Fujian Province.The survey covered topics such as water treatment system configuration,maintenance and water quality monitoring.RESULTS A total of 108 questionnaires were distributed and 104 valid questionnaires were collected,with an effec-tive response rate of 96.30％.The survey revealed that 78.85％(82/104)of the hospitals adopted separate water supply for each department,and 82.69％used purified water for terminal rinsing.Only 19.23％installed the final filter membrane at the water outlet.In addition,66.35％of the hospitals did not specify the service life of the wa-ter supply pipeline,and the pipeline disinfection implementation rate was 60.58％,but 31.75％of them had ir-regular disinfection frequencies,with chlorine-based disinfectants(50.79％)and peracetic acid(34.92％)being the main disinfectants.The regular conductivity monitoring rate was 47.12％,and the microbial monitoring cov-erage rate reached 90.38％,with the monitoring frequency mainly being once every quarter(60.64％),but only 20.21％used R2A medium,and 12.77％adopted the membrane filtration method for inoculation.Tertiary hospi-tals were superior to secondary hospitals in terms of film membrane pore size pass rate(87.50％vs.56.86％),pipeline disinfection implementation rate(71.43％vs.50.91％)and advanced detection method application(P＜0.05).CONCLUSIONS There are issues in the management of water used for terminal rinsing of digestive endo-scopes in Fujian Province,including non-standard equipment maintenance,inconsistent monitoring methods and insufficient awareness among management personnel.It is recommended to enhance management quality by optimizing the water treatment system setup,establishing standardized monitoring procedures and strengthening professional training for personnel.

Objective:Screening factors that might influence rheumatoid arthritis (RA) complicating interstitial lung diseases (ILD) by constructing and validating a model for early diagnostic.Methods:The study subjects were composed of 712 RA patients in the Department of Rheumatology and Immunology of the Second Hospital of Shanxi Medical University during December 2019 to October 2022. Fifty-two variables such as their demographic data, clinical symptoms, and laboratory indexes were collected. Patients were categorized into RA-only group and RA-ILD group with or without the occurrence of ILD disease. After data preprocessing, subjects were randomly assigned to the modeling and validation groups in a 7:3 ratio.Univariate analysis comparing baseline characteristics of the two groups of patients. Feature selection was performed using LASSO and SVM-RFE regression algorithms.Screening indicators were analyzed by logistic regression and the results were used to develop a nomograms model for the early diagnosis of RA complicating interstitial lung disease; and the modeling group was evaluated for its performance for internal assessment of the model and internal validation using data from the validation group.Results:A total of 712 subjects participated in the study, of which 498 in the modeling group and 214 in the validation group. Univariate analysis showed that the differences between the two groups were statistically significant ( P<0.05) in 18 characteristic indexes, including male, gender, age, smoking history, drinking history, number of swollen joints, number of painful joints, use of prednisone, WBC, ESR, CRP, IL-2, IL-10, IL-17, TNF-α, INF-γ, AFA family, APF, and serum albumin. The LASSO algorithm identified 13 risk variables for RA-ILD, the SVM-RFE algorithm identified 12 variables for RA-ILD, and the intersecting risk variables were male, age, history of alcohol consumption, number of painful joints, prednisone acetate, IL-2, AFA family, TNF-α, serum albumin, and IL-10. The results of multifactorial logistic regression analysis confirmed that the differences between males [ OR(95% CI)=3.61(2.11, 6.18)], gender, age [ OR(95% CI)=1.05(1.03, 1.08)], number of painful joints [ OR(95% CI)=1.03(1.01, 1.06)], IL-2 [ OR(95% CI)=0.91 (0.84, 0.99)], and TNF-α[ OR (95% CI)=1.06 (1.02, 1.10)] were statistically significant ( P<0.05) and were independently influences on ILD complicated by RA. The modeling and validation groups that were used to construct early diagnostic Nomograms had high calibration curve accuracies, and the model had a high diagnostic power, which was mainly demonstrated by the receiver operating characteristic (ROC) area under the curve (AUC) and decision curve analysis(DCA), the model modeling group had an AUC of 0.76 (95% CI=0.71, 0.81), with net benefit rates of 3%~82% and 93%~99%, whereas the model validation group had an AUC of 0.71 (95% CI=0.64, 0.79), with net benefit rates of 5%~11%, 14%~60% and 85%~89%. Conclusion:Male, gender, age, number of painful joints, IL-2, and TNF-α are independent factors for RA complicated with ILD, and the Nomogram model constructed has good performance in early diagnosis of the disease.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Objective To evaluate the efficiency of fluorescent PCR melting curve method in early diag-nosis of fluoroquinolones (FQs) resistance in the patients with tuberculosis,and to analyze the situation and characteristics of FQs resistance,so as to provide a basis for the standardized diagnosis and treatment of rifam-picin resistance/multidrug resistant tuberculosis (RR/MDR-TB) and pre-extensively drug resistant tuberculo-sis (pre-XDR-TB).Methods A total of 1094 smear positive samples from the outpatients and inpatients of Guiyang Municipal Public Health Treatment Center from January 2021 to August 2022 were collected and conducted the Roche solid culture method and bacterial species identification.Finally,589 cases of tuberculosis conducted the phenotypic drug sensitivity test and fluorescent PCR melting curve method for detecting rifam-picin (RFP),isoniazid(INH),ethambutol(EMB) and FQs resistance.The phenotypic drug sensitivity test served as the standard to evaluated the diagnostic efficiency of the fluorescent PCR melting curve method;the relationship between the patients' FQs resistance and clinical characteristics was analyzed according to the phenotypic drug sensitivity results.Results The sensitivity,specificity,coincidence rate and Kappa value of fluorescence PCR melting curve method for detecting FQs drug resistance were 91.30％,97.69％,96.94％ and 0.86 respectively;the area under the curve (AUC) was 0.945,which was higher than 0.924,0.923 and 0.850 of RFP,INH and EMB.The drug resistance rate of FQs in the patients with RR/MDR-TB was 22.80％,the Kappa value of fluorescence PCR melting curve method for detecting the patients' FQs drug re-sistance was 0.83,the consistency was good,AUC was 0.936.There was no statistically significant difference in sensitivity,specificity and coincidence rate of FQs resistance in TB patients with different bacterial loads by fluorescence PCR fusion curve (P>0.05).The treatment type,history of anti-tuberculosis,pulmonary cavity and MDR-TB were related with FQs resistance (P<0.05).Conclusion The fluorescent PCR melting curve method has good diagnostic efficiency for FQs resistance in the patients with tuberculosis.

Objective:To investigate the mediating roles of the fear of missing out and mobile phone addiction between the basic psychological needs satisfaction and phubbing behavior among high school students.Methods:In April 2022, a cross-sectional design survey was conducted on 14 666 high school students. All participants were evaluated by the basic psychological needs scales(BPNS), generic scale of phubbing(GSP), trait-state fear of missing out scale(T-S FOMOS) and mobile phone addiction index(MPAI). The SPSS 26.0 software was used to conduct common method deviation test, descriptive statistics, and correlation analysis.PROCESS 4.1 was used to construct the model, and the Bootstrap method was used to test for mediating effects.Results:(1)Among the 14 036 high school students, there were 1 752 (12.48%) students who were addicted to mobile phones.There were significant differences in gender in the scores including BPNS(boy: 4.43±0.79, girl: 4.36±0.79), GSP(boy: 2.72±1.01, girl: 2.76±1.03) and T-S FOMOS(boy: 1.73±0.60, girl: 1.84±0.64), ( t=5.22, -10.58, -2.78, all P<0.01). Among different grades, there were significant differences in the scores of BPNS, T-S FOMOS, MPAI, and GSP( F=25.43, 39.50, 53.45, 14.59, all P<0.01). (2)Basic psychological needs score were positively correlated with fear of missing out, mobile phone addiction and phubbing( r=-0.432--0.294, all P<0.01). Phubbing were negatively correlated with fear of missing out and mobile phone addiction( r=0.744, 0.538, both P<0.01). Fear of missing out were negatively correlated with mobile phone( r=0.646, P<0.01). (3)The basic psychological needs satisfaction had a direct effect on phubbing behavior, and the effect value was -0.188 (95% CI: -0.173--0.204). The mediating effect of fear of missing out between the basic psychological needs satisfaction and phubbing behavior was -0.035(95% CI: -0.028--0.042). The mediating effect of mobile phone between the basic psychological needs satisfaction and phubbing behavior was -0.203(95% CI: -0.191--0.214). Fear of missing out and mobile phone addiction played a chain mediating role between them, and the mediating effect value was -0.134(95% CI: -0.125--0.143), which accounted for 23.93%(-0.134/-0.560) of the total effect. Conclusion:The high level basic psychological needs satisfaction can alleviate the occurrence of phubbing behavior. It may be achieved by decreasing fear of missing out and reducing mobile phone addiction.

With the widespread adoption of smartphones， mobile phone addiction among adolescents has emerged as a challenging public health concern. This paper aims to undertake a comprehensive literature review on mobile phone addiction among high school students， both domestically and internationally. It primarily focuses on exploring the conceptual framework， measurement tools， epidemic status， influencing factors and intervention strategies associated with mobile phone addiction in this specific population， so as to provide references for interventions targeting mobile phone addiction among high school students， with the ultimate goal of reducing the incidence rate within this population. ［Funded by Sichuan Provincial Primary Health Development Research Center in 2022， North Sichuan Medical College （number， SWFZ22-C-89）， Mianyang City Social Science Research Key Base-Sichuan Mianyang Minor Psychological Growth Guidance and Research Center 2022 Annual Funding Project （number， SCWCN 2022YB07）］

ObjectiveTo investigate the mediating role of loneliness and social anxiety in the relationship between basic psychological needs satisfaction and smartphone addiction among high school students， and to provide references for the intervention to smartphone addiction for high school students. MethodsIn April 2022， a total of 14 666 high school students from 5 middle schools in a county of Sichuan Province were included by random sampling method. Basic Psychological Needs Scales （BPNS）， the UCLA Loneliness Scale-3 edition （UCLA-3）， Interaction Anxiousness Scale （IAS） and the Mobile Phone Addiction Index （MPAI） were used for cross-sectional investigation. Bootstrap method was used to analyze the mediating role of loneliness and social anxiety in the relationship between the basic psychological needs satisfaction and smartphone addiction. Results① In this study， 14 036 valid questionnaires were returned， and 1 752 （12.48%， 95% CI： 0.114~0.136） high school students were found to be addicted to smartphone phone. The BPNS score was negatively correlated with UCLA-3， IAS and MPAI scores （r=-0.771， -0.486， -0.417， P<0.01）. And MPAI score was positively correlated with IAS and UCLA-3 scores （r=0.403， 0.424， P<0.01）. IAS score was positively correlated with UCLA-3 score （r=0.458， P<0.01）. ②The degree of basic psychological needs satisfaction in high school students can directly negatively predict smartphone addiction （β=-0.383， P<0.05）， and can also indirectly affect smartphone addiction through loneliness and social anxiety （β=-0.130， P<0.05）. ③Loneliness （indirect effect value was -0.145） and social anxiety （indirect effect value was -0.074） partially mediate between the basic psychological needs satisfaction and smartphone addiction. Loneliness-social anxiety also has significant chain mediating effect （indirect effect value was -0.034）， which accounted for 8.88%. ConclusionThe basic psychological needs satisfaction can not only directly affect the occurrence of smartphone addiction， but also indirectly affect the occurrence of smartphone addiction through the chain mediation of loneliness and social anxiety.